Paediatrics: Common mixing: complete atrioventricular septal defect

Common mixing: complete atrioventricular septal defect

Complete AVSD is often found in conjunction with Down syndrome. There is a large defect often from the middle of the atrial septum down to the middle of the ventricular septum. In addition there is not a separate mitral and tricuspid valve, but there is a common atrioventricular valve of 5 leaflets guarding the atrioventricular junction.

Clinical features

Most patients with Down syndrome are screened for congenital heart disease with an echocardiogram. An ECG will show a superior axis.

Treatment

·  Medical: treat heart failure if present.

·  Surgery: is performed at 3mths of age, before pulmonary hypertension causes pulmonary vascular disease (Eisenmenger syndrome).